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Wednesday, January 13. 2010
I have been thinking quite a bit about Sociopathy (aka Antisocial Personality, aka Psychopathy, aka in the young "Conduct Disorder") lately. People without a conscience who view others as objects of gratification or as tools to be used. I have missed the diagnosis several times over the past few years, to my regret. Many experts are known to miss it until something happens to wave the red flag in front of your face.
It's not just an important diagnosis for us shrinks to make: it's important for everybody out in the world. 2-3% of humans probably have enough sociopathic traits to be of concern in life. It's a strange partially genetic adaptation. Some end up as leaders and moguls, many end up addicts, dead, or in jail. Sociopathy knows no economic, cultural, or ethnic boundaries.
What is this "condition"?
It's a tricky thing, sociopathy. It has been well-described from many points of view. We analysts often think of it as being based in an absence of empathy - an inability to experience others as other than as objects to be exploited, used, predated upon, etc. An inner coldness and calculatingness towards others, but not to be confused with obsessional personalities who simply protect their emotions, and not be confused with those with immoral or amoral impulses - everybody has those.
However, successful sociopaths learn to create a warm, caring, engaged, and often charming presentation of themselves to the world. Very successful and smart sociopaths learn how to live honest lives and to channel their talents, guile and wiles into honest paths.
Full-blown sociopathy is generally considered an untreatable and incurable condition. I am not convinced that that is true - but I think it requires special methods which are outisde of regular Psychiatry. Sociopathic traits are far more common than the supposed 2% of the population that are said to be full sociopaths. I am not going to write an essay on this complicated topic, but will just offer some links for those who are interested:
Wiki has a simple introduction to the topic
A classic book by Cleckley: The Mask of Sanity: An Attempt to Clarify Some Issues About the So Called Psychopathic Personality
An interesting paper: THE SOCIOBIOLOGY OF SOCIOPATHY: AN INTEGRATED EVOLUTIONARY MODEL
I have more links on the topic, but no more time right now.
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Fascinating subject(s). It's fun for me to wonder whether various historical figures are examples. But when I read something like this...."Any individual antisocial may exhibit none, one or more than one of the following:" I know a charlatan (Millon) has attained status as an authority. From then on, I'm severely skeptical of claims of scientific/therapeutical knowledge regarding people who are just plain naughty. Maybe in a couple of centuries.....
“Therapy is about re-educating a person by playing a parental role. No one should be paying for an "enlightened witness" to find relieve for the suffering that you never caused yourself in the first place. In that regard, therapists are cowards dealing with victims instead of the perpetrators.”
I do not wish to gain say Dr. Bliss as she's much more learned than I, but (ain't there always a but) the truth of how people behave is simple - we live on the face of this planet, eat our food, drink our coffee but we "live" on a world somewhere else - worlds of our own that orbit very nicely around the center of our heads.
The constant search to classify human behavior is a fruitless exercise. Reading the definition of sociopathy, it seems to me that every parent has experienced all the indicators with their kids when they became teenagers.
Which proves the axiom that all behaviors are true for any given value of true.
Whether volitional behaviors are proper concerns for healers is not, IMHO, established. It has been assumed.
It makes as much sense to me to ascribe evil or uncooperative motives to demon possession as to health.
Yes, there are intoxication, hormone imbalance, lesions, genetic disorders, and so on. Those can affect behavior. Unless physiological causes can be demonstrated, it is irrational to assume illness or trauma are present. The healing arts, however, are grandly ambitious.
No one should be surprised that drugging "mental patients" changes their behavior; if you disagree, drink two tall glasses of Long Island Iced Tea, and then we'll discuss it. Reactions to drugs prove nothing about the aetiology of the "diseased" motives/behaviors, nor does pharmacology offer any kind of treatment or cure.
Some "mental patients" do get better, especially those suffering from depression. They may not benefit from any treatment, though. Consider: I have a headache; I take an aspirin; my headache disappears. The pill did it. Fallacy: post hoc ergo propter hoc. I don't know why I lost my headache; it might have gone away no matter what.
Drugs may make the "patient" less difficult. To distressed family and friends, that counts as therapeutic.
Yes, physicians may be curing mental illness with drugs. We can't know whether that is happening. Is it a cure, or behavior modified by intoxication?
It is even harder to spot sociopaths in a culture thick with narcissists. These 2 are very close together on the continuum between altruism and apathy.
Look at Dr. B's definition of sociopathy:
People without a conscience who view others as objects of gratification or as tools to be used.
This matches the clinical description of Narcissistic Personality Disorder in the DSM.
It's just a matter of degree in ruthlessness. One could say sociopaths are narcissists who cause damage that is physical/shocking/publicly acknowledged, while garden-variety narcissists are just as bad - but their damage to others is emotional and private.
That seems very reasonable to me.
I wonder whether it makes sense to put all this in a health/disease/therapeutic context. It seems to me it belongs in ethics.
Maybe psychology is involved, especially when child-rearing practices result in anger, hostility, resentment, selfishness, etc., in the adult. But "healing" people who are ethically deprived/depraved seems to me to be the wrong word and the wrong concept.
Suppose we say we want to help them understand why they cause problems for themselves. Isn't that instruction aimed at developing ethical insight?
We can call it healing, I suppose, but then we (and Big Brother) can define or name anything irrationally, can't we? We can even define things that don't exist, and believe in them because now they have names. ("Mental illness" for one, heh, heh.) I have forgotten who pointed out that if our guts made as many mistakes as our minds make, we would none of us survive our first meal.
Interesting site and book that deals with psychopathy
I would like to have a way to treat this not for the sociopath but my self since i live with one, LONG story, but I am sane and just getting to know what I am dealing with? anyone can give me some advise...? please, thank you for your time